Administrative Solutions in Health Reform: Administrative Issues in Expanding Access to Health Care

The U.S. health care system faces well-known challenges: 46 million people without health insurance coverage in 2007, rapidly rising costs that now consume over 16 percent of the nation’s economic output, and uneven and inequitable quality of care.

The National Academy of Public Administration and the National Academy of Social Insurance partnered with the Robert Wood Johnson Foundation to undertake a sweeping analysis of the management and administrative issues that arise in expanding health coverage. The two-year project identified and described core administrative functions that need to be performed regardless of the health system in place, and assessed how these functions might be performed under different health care alternatives. The panel drew lessons from experiences both in the United States and abroad, and recommended administrative and management approaches designed to facilitate the improvement and expansion of health care coverage.